India is gearing up to strengthen tuberculosis (TB) control so as to provide TB prevention, diagnostics and treatment, particularly for multi-drug resistant tuberculosis (MDR-TB), nation-wide by 2010.
MDR-TB is TB that is resistant to at least two of the best anti-TB drugs, isoniazid and rifampicin. These drugs are considered first-line drugs and are used to treat all persons with TB disease.
"The 4th Global Survey on anti-TB drug resistance does not indicate that the rates of MDR-TB are increasing sharply in India or in Indonesia, or in the South-East Asian Region as a whole. The overall rates for MDR-TB among new smear-positive cases in the Region is 2.8% among new cases and 18.8% among people receiving prior treatment for TB for one month or more. However given population sizes in our larger countries, the numbers of cases are indeed large" said Dr Jai P Narain, Director, Communicable Diseases Department, South East Asian Regional Office (SEARO) of the World Health Organization (WHO).
MDR-TB is a result of inadequate programme performance of Directly Observed Treatment Short-Course (DOTS). DOTS is the WHO-recommended treatment strategy for detection and cure of TB which combines five elements: political commitment, microscopy services, drug supplies, surveillance and monitoring systems and use of highly efficacious regimes with direct observation of treatment.
"National TB control programmes in our Region have moved steadily to achieving the case detection and treatment success targets under DOTS. Treatment success rates in excess of 85% have been consistently achieved since 2002" further explains Dr Narain.
However due to a broad range of reasons, some people with drug-susceptible TB (which is not resistant to any anti-TB drug) develop resistance to anti-TB drugs, or may contract the drug-resistant strain of TB, which is also a possibility. People living with HIV (PLHIV) or those with compromised immunity are at particularly alarming TB risk (both drug susceptible and drug-resistant TB strains).
"MDR-TB cases arise among patients failing Category 1 and 2 regimens, contacts of MDR-TB cases, congregate settings and in other at risk populations such as PLHIV" adds Dr Narain.
Testing or diagnosing these drug-resistant strains of TB and providing effective medication (which is many times more expensive, and treatment duration is much longer) and improving DOTS programme performance for successfully diagnosing and curing drug-susceptible TB (and preventing development of any further anti-TB drug-resistance) can certainly make TB control more effective.
"We see this as an opportunity to strengthen our efforts to focus on prevention of MDR-TB so that we do not have to make the larger investments in treating additional cases of MDR-TB" says Dr Narain.
"India has adopted policy and is now rapidly building laboratory capacity through a network of 24 reference laboratories qualified to undertake culture and drug susceptibility testing (DST) to offer testing to all those who may have drug-resistant forms of TB. There is also an expansion plan to treat MDR-TB cases country-wide by the end of 2010" informs Dr Narain.
Dr Narain points out two specific areas that require attention: To determine how/ where MDR-TB is being generated, and to prevent further emergence of MDR-TB.
While achieving good cure rates under DOTS, we need to focus also on reasons for default and other unfavourable outcomes" says Dr Narain. "Given good cure rates under DOTS, are most MDR-TB cases arising from unsupervised treatment, through unsustainable out-of-pocket expenditure, outside of DOTS programmes?" asks he.
Dr Narain suggests some ways to prevent further emergence of MDR-TB. "By addressing all causes of adverse TB treatment outcomes, enhancing involvement of private sector and unlinked public health facilities, and promoting wider acceptance and application of the International Standards of TB Care" can possibly improve TB programmes in the region.
(The author is a Special Correspondent to Citizen News Service (CNS). He can be contacted at: amit@citizen-news.org)
The first Horizon Series Cultural Programme of the year 2013 was successfully held on 5th January 2013 from 6 pm onwards at Soul Speak Studio hall, Dimapur. The main programme saw performances from three artistes- Chuba Jamir, Kagholi Chisi and Toshi Aier.Chuba Jamir, who is also known as Kishore Kumar of Nagaland presented songs in Hindi, Engish and Ao including his latest remix of the you tube sensation Gangnam Style in Hindi which turn out to be a hit with the audience. Kagholi Chisi sang a few cover songs and Toshi Aier presented 3 Ao songs.A regular feature of Horizon Series programme is the open mic cum jam session with the intention of giving a platform to artistes wanting to perform...
ULFA seems to have stepped up its activities in the run up to the Republic Day. A hardcore ULFA militant was killed in an encounter with security forces in Assam's Tinsukia district. Acting on a tip-off about the presence of a group of five ULFA cadres in Hebeda village, police launched an operation in the area.In an ensuing encounter the militant was killed while others managed to escape. The slain militant was identified as Debojit Duara alias Wangli Asom. His elder brother, also a suspected ULFA militant, was killed in an encounter in 2007. Police recovered a grenade and some ammunition from the slain militant. A massive combing operation was launched in the area to arrest other...
Security forces recovered two Improvised Explosive Devices from Nagajan area near Duliajan on Friday evening.The IEDs were planted near oil pipe lines in the area. Later, the army's bomb squad team defused the IEDs. ULFA’s anti-talk faction led by Paresh Baruah is active in upper Assam and is trying to trigger explosions in few areas ahead of the Republic Day.
Massive protest over rape and molestation is spreading across the state on Saturday. Members of the All Assam Association of the Deaf staged a demonstration here to protest against the rape of a mentally challenged woman allegedly by CRPF men in Lakhimpur district.Wearing pieces of black cloth across their mouths and held placards, the protestors shouted slogans demanding capital punishment for the culprits.The protest was triggered by an incident in North Lakhimpur, when two CRPF personnel allegedly raped a mentally challenged woman in Chaulduwa area in Lakhimpur town on Thursday.
Tinsukia police have arrested five persons for gangraping a 13-year-old girl on Friday. The incident took place at Sukanpukhuri tea estate under Makum police station on the intervening night of January 2-3 after one of the accused, Jogeshwar Mali, lost his cellphone.According to police, Tusu incited her husband and his friends to punish the girl and the four caught hold of the girl at a lonely stretch of the estate and raped her.The police arrested Tusu, Mali and his friends Sanesh Nayak, Tirnath Mali, Ram Chandra Patnaik after the girl told the family about the incident.
A lower court in Lakhimpur has jailed a CRPF jawan on Friday charging him with raping a physically challenged woman on Thursday. Three of his colleagues are on the run. The incident took place at Chauldhowa village. According to eyewitness, about four CRPF personnel forcibly took the physically challenged woman, who was passing by the CRPF camp on NH 52 in the area to the nearby jungle. Some locals raised an alarm. While they managed to catch Mohan Singh, the others fled. The victim has been sent for medical examinations.
In a huge setback for Congress ahead of the panchayat elections, a senior Congress leader in BTAD area has been sent to jail on Friday a day after he was caught red handed when he found with a woman Thursday morning. BTC Congress Committee chief convener Bikramsingh Brahma who stayed at the woman's house had forcefully slept with the victim to be discovered by her husband.After being thrashed by local residents, police produced him before the Chirang court on Friday where he was remanded to judicial custody. The Congress has expelled Brahma from the party.
Every year the Education Research and Development Foundation (ERDF) honors eminent personalities of the state in recognition of their contribution in different fields to mark the advent of New Year. This year ERDF selected some senior citizens of the state to wish good health and long life so that they can continue their service to the society.The 2013 edition of the felicitation programme was held at the Regional Institute of Science & Technology (RIST) for ten senior citizens. The function began with welcome address of the dignitaries to the Dais by N I Laskar, Director, Corporate Communication ERDF. Dr H K Baruah, Director (Academics), ERDF welcomed the guests. Felicitation of...
A cycle rally was set on the roll at Bokakhat this morning with an objective to generate awareness among the masses for conservation of precious wildlife in Kaziranga National Park and its fringe areas in Assam. The rally has been organised by Aaranyak, a society working for bio-diversity conservation in association with Upatyaka, a conservation organization and State Forest Department.The rally which will culminate on January 5 at Garhpal, Sootea in Sonitpur district in the North Bank of Brahmaputra, was flagged off today at Bokakhat by local MLA Arun Phukan in presence of Kaziranga NP Director N.K. Vasu, prominent citizens of Bokakhat, officer-in-charge of Bokakhat Police station,...
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The Assam Times is an online news portal that tells the tales of people from all walks of life. “Assam” here does not confine to today’s geographical boundary and goes beyond the barriers. We welcome news and articles on/from the entire northeastern states - Arunachal Pradesh, Nagaland, Manipur, Mizoram, Tripura, Sikkim and Meghalaya. First time writers, please send a short note about yourself along with your Facebook/Twitter ID, contact details and a small photograph for your Reporter's ID Card.
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